• 4/1/2007
  • San Antonio, TX
  • Don Finley
  • MySA.com

Slightly fewer than half of all patients diagnosed with head and neck cancer live five years from the moment the doctor delivers the bad news. But those who do survive two or three years out have a better chance of living another five. Doctors just weren’t sure exactly how much better that chance was — until now.

A San Antonio-led group of researchers has calculated those “conditional” survival rates — the five-year survival odds beginning a year or more after diagnosis — for head and neck cancers (excluding brain cancer), which account for 3 percent to 5 percent of all cancers.

Such information has been available for breast, lung, brain, prostate and gastrointestinal cancers, but not head and neck cancer.

“Head and neck cancer remains a disease where we still have a lot of progress to make,” said Dr. Clifton David Fuller, a radiation oncology resident at the University of Texas Health Science Center and the lead author of the study that appears in the current issue of the American Cancer Society journal, Cancer. “Comparatively, few resources are devoted to it.”

Head and neck cancers are heavily linked to smoking and alcohol consumption. They’re most common in people over age 50. An estimated 39,000 Americans developed head and neck cancers last year.

Head and neck cancer sites include the lip, tongue, throat, nasal cavity, middle ear and other places. Most tumors begin in the squamous cells that line the mucous membranes.

To calculate survival odds, the researchers examined data collected by the National Cancer Institute for 76,181 U.S. patients diagnosed between 1973 and 1998.

Among all head and neck cancer patients, 47.8 percent lived five years from the time of diagnosis. That rose to 54.7 percent after one year, 61.4 percent at two years and 64.4 percent at three years.

The survival odds for individual head and neck cancer sites varied. Among patients with cancer of the oropharynx — the part of the throat at the back of the mouth — 26.5 percent survived five years from diagnosis, rising to 50.4 percent three years later.

“There’s some hope and there’s some caution” in the findings, Fuller said. “The hope is for patients who have survived some period of time. Their prognosis is better than when they were first diagnosed. But also caution, because a very small number of patients make it to five years.”

Because those patients are older and often are heavy smokers and drinkers, they can be unhealthy to start with, Fuller said. Many developed secondary cancers, or die of heart disease or other causes, Fuller said.

One of Fuller’s co-authors, Dr. Samuel Wang of the Oregon Health and Science University in Portland, is using the patient data to build an online survival calculator for use by doctors and patients. But the researchers, who also include surgeons from University of Texas M.D. Anderson Cancer Center in Houston and the University of Iowa, hope to refine the information and make it more sophisticated — to determine, for example, how often a patient should be screened after treatment to see if cancer has returned.

“Using the results of this study, we can now tell head and neck cancer survivors how their prognoses may change over time,” Wang said. “This often will be good news for patients because we found that most patients’ prognosis improved after they survived longer periods of time from when they were first diagnosed and treated.”